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Ask Dr.S.A.Alam Your Own Question
Dr.S.A.Alam
Dr.S.A.Alam, Doctor
Category: Health
Satisfied Customers: 4426
Experience:  MBBS/FCPS(Internal medicine/cardiology) MRCP(R) U.K
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Hi, I recently visited a nurse practitioner to have a routine

Customer Question

Hi, I recently visited a nurse practitioner to have a routine pap as well as std testing done. My IGG came back negative for HSV1 and HSV2 but she said my IGm came back positive. I have read that IGm testing is outdated and can produce false positive results due to the chemistry of the test itself. The nurse practitioner said that the IGm came back positive for HSV2 but I thought IGm's were not type specific? Please help. Thanks!
Submitted: 4 years ago.
Category: Health
Expert:  Dr.S.A.Alam replied 4 years ago.

Dr.S.A.Alam :

Hello, Thank you for your question,

Dr.S.A.Alam :

Your age ?

Dr.S.A.Alam :

are you sexually active ?

Customer:

27

Customer:

and yes

Customer:

but not for the last month

Dr.S.A.Alam :

Well both HSV 1 and HSV 2 have type specific antibodies that can be detected.

Customer:

okay

Dr.S.A.Alam :

IgM means that there is acute infection

Customer:

but I have read that only the IGG test can be truly accurate

Dr.S.A.Alam :

that is less than 4 weeks old.

Dr.S.A.Alam :

while IgG means a chronic infection or previous exposure to this virus.

Customer:

okay

Customer:

but is it possible for igm to have a false positive result?

Customer:

i have read this in many forums

Customer:

I am always very safe

Customer:

and don't understand how it could be possible

Dr.S.A.Alam :

These are pretty sensitive tests, false positive is less likely and can occur with other infections

Dr.S.A.Alam :

of herpes virus.

Customer:

but IGm is type specific? i have read that it is not

Dr.S.A.Alam :

It is true that IgM of HSV1 can give false positive for HSV2

Customer:

and that I should be retested in 12-16 weeks and only focus on my IGG

Customer:

okay

Customer:

so it's possible i have HSV1

Dr.S.A.Alam :

because their main structure is the same.

Customer:

and not HSV2

Customer:

that is something I have read

Dr.S.A.Alam :

Yes it is possible as these antibodies can give false results with one another.

Customer:

I have never had a symptom (I realize some people never show signs ever)

Customer:

I am just very worried and stressed

Dr.S.A.Alam :

So this may be the case.

Customer:

but I read that 80% of adults have HSV1

Dr.S.A.Alam :

Yes it is true

Dr.S.A.Alam :

more than 70% of population has it.

Customer:

so it is very possible that HSV1 was mixed up with HSV2?

Customer:

even if I've had signs of neither?

Dr.S.A.Alam :

so it is nothing to worry, ideal is to get it rechecked.

Dr.S.A.Alam :

Because if this was true positive then your IgG antibodies should be positive after

Dr.S.A.Alam :

4 weeks.

Customer:

I had my test 4 weeks after the previous sexual encounter

Dr.S.A.Alam :

HSV1 can be present in the body even without symptoms.

Customer:

both IGG's came back negative

Customer:

she said the igm was high

Customer:

does this make a difference?

Dr.S.A.Alam :

then there are high chances that it is false positive. IgM represent an acute infection that is less than 6 months old

Customer:

so the IgM would be accurate within 2 weeks of a sexual encounter?

Customer:

and not thereafter?

Dr.S.A.Alam :

and high titers means that less chance of false result, although it is not the criterion but less chances of being false if titers are high. So i would repeat this test after 4 weeks and see if it is still positive.

Customer:

okay

Dr.S.A.Alam :

IgM are acute while IgG appear after 4 weeks and can be delayed upto 6 months.

Customer:

okay

Dr.S.A.Alam :

SO best option is to repeat this test.

Dr.S.A.Alam :

You have more questions ?

Customer:

why does the CDC regulations say to not use iGm testing?

Customer:

yes sorry

Dr.S.A.Alam :

Because of high false results.

Dr.S.A.Alam :

they ask doctors not to use it

Customer:

so can I disregard until my next IGG exam?

Customer:

it's putting a lot of stress on me

Customer:

and I don't want to rely and worry about something that shouldn't be administered by doctors

Dr.S.A.Alam :

this test also comes positive with other types of viruses and some bacterial infections so CDC tell not to use it

Customer:

IGG's were both normal and IgM was high and that was all my nurse practitioner seemed to focus on

Customer:

she never told me that since IGG was negative that I should be retested in 4 weeks

Dr.S.A.Alam :

If IgG does not comes positive this also means that it was false positive.

Dr.S.A.Alam :

So best is to repeat it.

Dr.S.A.Alam :

Your questions ?

Customer:

I think that's it. So I can stop worrying until the next test?

Dr.S.A.Alam :

Wishing you best of luck.

Dr.S.A.Alam :

You have questions for me ?

Customer:

nope

Dr.S.A.Alam :

let me know.

Customer:

thanks

Dr.S.A.Alam :

Click ACCEPT if you have

Dr.S.A.Alam :

received your answer.

Dr.S.A.Alam :

And thank you for using justanswer.

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